We retrospectively reviewed the patients who underwent suprarenal resection of IVC without reconstruction for urologic neoplasms in our institution between September 2010 and October 2019. Patients’ demographic, clinical, radiologic, and 90-day perioperative complications were recorded.
Twenty-eight (79% male) patients with a median age of 59 (25-75) years were included in the study. Twenty-five (89%) of patients had renal cell carcinoma, one had renal leiomyosarcoma, and two had metastatic testicular teratoma. Twenty-two patients had Mayo level 3 thrombus, three had level 2 and three had level 4. The mean radiologic thrombus length was 12.6 cm. Eleven patients had radiologic bland thrombosis in the infrarenal IVC. Twenty-seven patients underwent open, and one robotic surgery. The median operating time was 411 (range 240-808) minutes, median blood loss was 3750 cc, and all but one patient received perioperative transfusion (median 11 units of packed red blood cells). Median hospital stay was 5 (3-50) days. 90-day complication rate was 35% (Clavien-Dindo grade I/II and III/IV were 21% and 14%, respectively). Four patients (14%) developed transient non-disabling leg edema. The 90-day mortality rate was 7%.
Suprarenal inferior vena cava resection without reconstruction is feasible, yet high-risk operation that should be performed in experienced centers in selected patients with urologic malignancies.
Copyright © 2020. Published by Elsevier Inc.